Provider Demographics
NPI:1790730976
Name:HILL, JILL C (FNP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:C
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RUE LOUIS XIV
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5739
Mailing Address - Country:US
Mailing Address - Phone:337-769-7779
Mailing Address - Fax:
Practice Address - Street 1:917 COOLIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2433
Practice Address - Country:US
Practice Address - Phone:337-237-5774
Practice Address - Fax:337-237-4939
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN089823AP04760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00275513OtherRAILROAD MEDICARE GRP PIN
LA1628549Medicaid
LA1628549Medicaid